WASHINGTON: President Barack Obama's landmark health care reforms take effect on Wednesday, granting coverage to millions of previously uninsured Americans after nearly four years of bitter wrangling that has loomed large over the US political landscape.

Since the Affordable Care Act, or "Obamacare", was passed in 2010, the legislation has survived multiple repeal attempts by Republican lawmakers, a US Supreme Court hearing, and a disastrous rollout of the website set up to assist the launch of the legislation.

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